Hearing aids can address hearing loss. But, to improve communication we must practice active listening and learn how to become a better listener.

Hearing is a sensory-based, passive process. As with blinking your eyes, hearing is an involuntary act. Hearing (assuming the person has normal hearing) takes no effort. It is ongoing without the person consciously realizing it. Listening, however, is a voluntary act. That is why we can learn how to become better listeners.

People with hearing loss often experience difficulty in processing speech. This makes it challenging to understand what is being communicated. With sensorineural hearing loss (SNHL), which accounts for as much as 90% of all hearing loss, higher-pitched tones sound muffled. This often makes it difficult to separate the conversation from the noise in the room.

 Hearing healthcare professionals can advise on the use of amplification, assistive hearing accessories, and listening strategies to improve hearing. But, once they remove these sophisticated tools, a person’s biological hearing ability returns to “impaired” status.

What is listening?

Listening is a voluntary act and an active process that requires conscious attention. It requires people to ignore distractions, and focus on what a speaker is saying. Paying attention has everything to do with listening and cognition. Listening is applying meaning to sound. It allows the brain to organize words, establish vocabulary, learn, and internalize concepts. How to become a better listener is a skill that can be developed.

An active listener pays attention to the auditory input that the brain receives. They then apply meaningful content to the situation. This process facilitates improved memory of the incident. This makes it easier to recall the relevant information as required.

The need for improved listening skills remains useful as long as they are intentionally engaged. Listening is a cognitive skill established on learned behaviors and associated rewards. Psychologists have shown that when people think about the meaning of new information, they are more likely to assimilate it. This allows them to learn, and remember, most of the information via rote memory.

The process of active listening is different for children. When adults (with normal hearing) listen to auditory input, the incoming sounds are recognized by the brain. An adult brain already understands language, vocabulary, and cognition. Children, however, apply a different strategy to listening. The human auditory brain structure only matures around age 15. Thus, a child does not bring a complete neurological system to a listening situation. Children do not have language and life experience. This experience is what enables adults to “fill in the gaps” of missed or inferred information. This is auditory/cognitive closure. Children require more, and detailed, auditory information than adults. Compared to normal-hearing adults, all children need a quieter listening environment. They also need a louder primary signal to create new neural maps and to develop their brains. Children who are hearing impaired need an added signal-to-noise ratio of +10 to +15 dB.

Learning to listen

One of the primary means of learning to listen is incidental hearing. Incidental hearing occurs through “overhearing.” This is when children listen to speech that is not directly addressed to them, yet they learn from it. Very young children learn approximately 90% of information incidentally. This learning leads to the development of expressive and receptive language. Incidental learning only occurs if a child has access to conversations or sound sources close to them.

Hearing over a distance can be difficult for anyone, especially for people with hearing loss. Anyone with hearing loss is more likely to struggle to listen and engage in conversations over a distance.

It’s important to address both hearing loss and cognition to ensure optimal communication. Hearing aids can address hearing loss, but to truly improve communication, a person has to practice the art of active listening.

Active listening

Active listening strategies are very effective in improving communication.  Here’s how people can improve their listening skills.

Be prepared for conversations:

1. Be more open about hearing loss as people are more likely to be accommodating to specific needs.
2. Face the person speaking and sit closer to them.  Have a view of their face and body language for extra cues on what they may be saying.
3. Turn the better hearing ear closer to the person speaking. 
4. Reduce background noises whenever possible. If visiting someone, ask them to accommodate hearing needs.
5. In a social setting or restaurant, find a quieter corner for better communication. This includes closing any open doors or windows that can increase external noise.
6. Avoid carrying on conversations from another room.
7. Become familiar with the way different people express themselves. Like facial expressions, vocabulary, sentence structure, accent, dialect, etc.
8. Practice active listening to improve listening skills.
9. Optimize the lighting, it should be in a position that allows a person to see the speaker as clear as possible.
10. Hearing aids with dual microphones can amplify sounds in front, and reduce sounds from behind.
11. Get to know all the functions of your hearing aid that can be adjusted to assist with listening. 
12. In the case of frequently used spaces, such as a home or office, consider improving the acoustics of the room. This includes installing carpeting, draperies, padded furniture, or acoustic ceiling tiles.
13. When attending a play, concert, church service, or lecture, try to arrive before the start time. Then get a seat as close to the front as possible. Request an assistive listening device.
14. Assess the situation in public places before attributing it to hearing loss. It may be due to a faulty public address (PA) system, a poor speaker, or high background noise.
15. Maintain realistic expectations about what can be heard in various situations and environments. There will be some situations where listening will be more difficult. Use more effort and strategies to follow what is said. 
16. Practice activities that improve your auditory memory.  These are often available on apps. This is best advised by a hearing healthcare professional who will act as a guide on what is suitable.
17. When a mask is required, ask people frequently spoken with to wear masks with clear panels to help lip-reading efforts.

During the conversation:

1. Be prepared for conversations and be prepared to listen.
2. Concentrate on the thought or ideas that the speaker is expressing. Straining to understand every word can be an arduous task. 
3. Do not hesitate to ask someone to clarify the information that may have been missed.
4. Do not hesitate to tell people what they can do to make communication easier. Inform them of the importance of slower speech. They should be close and use facial expressions and gestures to get the message across.
5. Resist becoming distracted by other sounds. People who lose concentration will be more likely to become distracted.  Take listening breaks during long conversations.
6. A wandering mind won’t keep up with conversations. Avoid thinking about other activities.  Stay focused and present with the communication partner.
7. When taking information over the phone, repeat back what was heard to verify that it was correct.
8. Relax. Acknowledge that active listening demands a concerted amount of energy. It’s important to withdraw when needed.
9. Be open-minded in the conversation.  Try not to judge someone.  Listen without being critical.  Avoid trying to justify thoughts and beliefs. 
10. Be patient during conversations and think before speaking. Avoid interrupting the speaker.  Wait for a pause before interjecting with a question. Let them finish what they are saying. This may provide more information about the topic of the conversation. It will also reduce the frustration that can further hinder the conversation.  
11. Give regular feedback to the speaker and acknowledge what was heard.
12. Practice mirroring.  Sharing the same energy and emotions as the speaker makes it much easier to follow active listening strategies.  Acknowledge hearing and understanding with a smile or a nod.
13. Positive body language and facial expressions can set the mood for a conversation.  Acknowledging and understanding body language helps to interpret others better.  This can be a positive influence on awareness and listening during conversations.

Hearing in a noisy environment is difficult for everyone, including those with normal hearing. Acknowledge that it is reasonable to miss out on parts of a conversation. Don’t exert pressure to hear like an expert. Instead, use strategies that work.

Untreated hearing loss can leave someone feeling despondent and dispirited. With the right technology and learned strategies, hearing loss is manageable and treatable. It has allowed persons with hearing loss to continue living life to the fullest.